Inspection on 01/12/05 for The Gouldings

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Gouldings 10/09/08

The Gouldings 03/10/06

The Gouldings 19/07/05

The Gouldings 13/12/04

The Gouldings 03/06/04

The Gouldings 19/02/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Gouldings, The St Andrews Way Freshwater Isle of Wight PO40 9HW Lead Inspector Neil Kingman Unannounced Inspection 1st December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gouldings, The Address St Andrews Way Freshwater Isle of Wight PO40 9HW Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 752135 01983 756039 Isle of Wight Council Mrs Anne Lesley Willis Care Home 35 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (10) Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 persons between and including the ages of 50 to 65 years may be admitted for intermediate care. 19 July 2005 Date of last inspection Brief Description of the Service: The Gouldings is a purpose built three storey detached property located in a residential area of Freshwater. Mrs Anne Willis manages the home on behalf of the proprietors Isle of Wight Council. The town centre with its shops and amenities is about a half mile from the home. The stated aim of The Gouldings is to provide service users with intermediate and rehabilitative care with accommodation on all three levels. Service users are afforded ramped access from the car park into the home and to all areas of the building via a large passenger lift. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two unannounced inspections for the year at The Gouldings and took place over 6¼ hours. Core standards not assessed on this occasion had been assessed at the last inspection. The manager Mrs Willis was not available on the day so the inspector returned on 9 December 2005 to finish the inspection and discuss the outcome with her. The inspector toured the building, examined a selection of records and spoke with twelve service users, two care assistants, two assistant managers and a visitor. Service users were spoken with in small groups in the communal areas and individually in the privacy of their rooms. Six questionnaires were received from services users. Comments about the service were very positive and no concerns were raised. What the service does well: What has improved since the last inspection? What they could do better: The home takes emergency referrals, sometimes without a pre-admission assessment. This practice does not give assurance that care needs will be met. Additionally, where a risk to service users is identified an appropriate risk assessment must be carried out and recorded. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The manager confirmed that the home’s admission procedure includes a preadmission assessment prior to people moving into the home. This is a task carried out by the manager herself, or one of the assistant managers. The records of the most recently admitted resident lacked evidence of a preadmission assessment, or a summary of a care management assessment. Without this information there is no assurance that care needs will be met. EVIDENCE: The Gouldings has written criteria for assessing the needs of prospective service users. Both the manager and an assistant explained that they would undertake a pre-admission assessment wherever possible prior to people moving into the home. Also, it was commonplace for a new service user to have been a long-standing day care user whose needs would already be known. However, in the case of emergency admissions they would ensure an initial assessment was carried out within one to three days. Each resident has an individual care plan. Two plans were looked at, including one for a service user admitted about a week before the inspection. This plan Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 9 lacked a pre-admission assessment, due, according to the assistant manager to it being an emergency admission. There was no social services’ placement form or care management assessment to provide staff with the minimum of information to help with the initial assessment of need. Daily recording of information by staff was very detailed, and identified some concerns around a potential risk to other service users. Additionally, the information highlighted an inaccuracy in the initial assessment. There was no evidence of a risk assessment having been carried out. While recognising the inevitability of emergency situations it is important the registered person ensures that as much information as possible is sought, and obtained, before the admission is agreed. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 10 Medication is securely held and appropriate records are maintained. The home ensures that staff respect residents’ privacy and dignity at all times, especially with regard to the arrangements for health and personal care. EVIDENCE: The home has a dedicated medication room and doctors’ consultation room with facilities. Staff will support individuals who use the rehabilitation service to self-administer their own medication. Appropriate risk assessments were in place for several who undertake this procedure. To avoid confusion there are separate procedures for the administration, handling and disposal of medication for those in long stay, intermediate care and rehabilitation. Monthly medication reviews are carried out and three-monthly assessments of staff to ensure consistency of practice. At the time of the inspection all medication was held under secure conditions and records were noted to be in good order. Respect for the dignity of service users is covered in the induction programme for newly appointed staff. During the tour of the building the inspector noted Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 11 staff would knock before entering bedrooms. There are good telephone facilities for service users with two pay phones, one being fixed in a private room on the ground floor and another in the rehab’ unit. Each bedroom is fitted with a facility enabling service users to receive incoming calls. Medical examinations are carried out either in the service user’s own room or in the home’s medical treatment room. While there is shared accommodation available in practice it is only married couples that share. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14 Visitors are welcome at all reasonable times and are able to meet with service users in private. The Gouldings provides an intermediate care service where service users are actively encouraged to be independent and exercise choice. Autonomy and choice extends to all aspects of daily living including personalisation of rooms, and financial affairs. EVIDENCE: Details of visiting arrangements can be found in the home’s service user guide in each room. Generally there are no restrictions but visitors are asked to respect mealtimes wherever possible. Visitors and links with the local community are very much encouraged. The inspector saw evidence of a regular art group, memory club and volunteers that run the in house shop. Service users are able to receive visitors in private in their own rooms or in one of three private rooms within the home. The inspector noted several visitors in the rehab’ unit and had the opportunity to speak with one of them. The views of this person about the arrangements in the home were very positive. Service users are encouraged and supported to manage their own financial affairs. Staff confirmed that advocacy services are not normally needed as Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 13 relatives of both long-term residents provide support. However, there is a contact number available for the advocacy service if required. Service users are encouraged to personalise their rooms even though the majority are shortstay. The home would be able to accommodate pets in some circumstances. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: The home uses the Isle of Wight Social Services Adult Protection Procedure, which is a fairly substantial document in terms of detail. Adult protection is covered in some depth in the home’s training programme scheduled for all staff. The manager confirmed that all senior staff had received the training. Staff spoken with during the inspection were very clear about their responsibility to report issues of concern without delay. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The location and layout of the home is generally suitable for its stated purpose in providing a safe and comfortable environment for those who live and work there. Decoration and maintenance are ongoing and plans are in place to upgrade rooms on the first floor to enhance the facilities for service users. EVIDENCE: In terms of its location and layout the home is suitable for its stated purpose, being safe, well maintained and accessible by means of ramps and a passenger lift. The provision of a hairdressing salon, medication room, doctors’ consultation room, numerous toilets, activities room and several private quiet rooms is commendable. There is a programme of routine maintenance, which is carried out by a person employed for that specific role, and a system in place to ensure that environmental issues are addressed. This year, following an issue raised by staff a new staff kitchen area has been created. This has enabled staff to prepare their own drinks and snacks without having to use the existing kitchen facilities. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 16 The manager confirmed that plans are in place to upgrade service users’ rooms on the first floor to provide en-suite facilities. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29 The home provides an ongoing programme of NVQ training for staff to ensure service users are in safe hands at all times. Staff turnover is low and a robust recruitment procedure ensures residents are protected. EVIDENCE: The home employs a full staff team a proportion of which are team leaders. Additionally there are five assistant managers, catering, domestic and administrative staff, with bank staff according to the number and needs of service users. There is also a handyman and a minibus driver. The local authority training programme has ensured that the ratio of care staff qualified at NVQ level 2 or above exceeds 50 . At the time of the inspection the ratio of qualified staff was 53 . Two assistant managers are qualified at NVQ level 4 and two are undertaking the training. The home has a staff recruitment policy that includes an application form, job description, terms and conditions of employment and the required disclosure of criminal background declaration. A minimum of two written references is taken up and the local authority carries out police and POVA checks on all newly appointed staff before they commence work. During the inspection the recruitment records of all newly appointed staff were checked and found to be in good order. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 The home has effective quality assurance systems for measuring its performance based on seeking the views of residents. There is a sound system in place to ensure residents’ finances are safeguarded. EVIDENCE: The local authority has an annual development plan for the home, which involves service users’ surveys and user group meetings. Collective service management team meetings ensure best practice through the organisation and the authority’s statutory monitoring visits regularly canvass the views of service users, visitors and staff about service provision. The results of satisfaction surveys were available for inspection. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 19 The home provides a facility for safeguarding service users’ money or valuables on request. The inspector checked the integrity of the system in place and found it to be most satisfactory. Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement All new admissions to the home, so far as practicable must be accompanied by a pre-admission assessment of needs. The care plan must include a risk assessment, fully completed, which identifies the risk and sets out the measures to be taken to minimise the risk of harm to the service user. Timescale for action 31/12/05 1 OP3 13 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gouldings, The DS0000032200.V249053.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!